Abstract
Objective
To determine the prevalence, interference, and management of acute and chronic pain
among youth with cerebral palsy (CP) aged 5-18 years attending outpatient rehabilitation
services.
Design
A cross-sectional study using the Faces Pain Scale-Revised, Patient Reporting Outcomes
Measurement Information System Pediatric Pain Interference Scale, and the Cerebral
Palsy Quality of Life questionnaire. Where children were unable to self-report, parent
or caregiver proxy was obtained.
Setting
Outpatient rehabilitation.
Participants
Participants (N=280) with CP aged 5-18 years and their parent or caregiver. Self-report
was obtained by 45.7% (n=128) and proxy-report was obtained by 54.3% (n=152) of the
cohort.
Interventions
Not applicable.
Main Outcome Measures
Presence or absence of acute pain and chronic pain. Secondary measures were pain intensity,
pain interference, pain management, and quality of life.
Results
Acute pain and chronic pain were reported by 67.1% and 31.4% of participants, respectively.
Of those reporting acute pain, 42% also experienced chronic pain. Factors that increased
the odds of chronic pain were: predominately dyskinesia (odds ratio [OR]=3.52; 95%
confidence interval [CI], 1.64-7.55); mixed spasticity-dyskinesia (OR=1.93; 95% CI,
1.07-3.47); bilateral involvement (OR=3.22; 95% CI, 1.844-5.61) and Gross Motor Function
Classification System level IV (OR=2.32; 95% CI, 1.02-5.25), and V (OR=3.73; 95% CI,
1.70-8.20). Pain frequently interferes with sleep, attention, ability to have fun,
and quality of life. Short-acting pharmacologic analgesics, thermotherapy, hydrotherapy,
and massage were commonly used for pain management.
Conclusions
Routine screening for pain is critical for early identification and intervention.
Multimodal interventions are needed to address the biopsychosocial model of pain,
and should be tailored for all abilities across the CP spectrum.
Keywords
List of abbreviations:
CFCS (Communication Function Classification System), CI (confidence interval), CP (cerebral palsy), CPQOL (Cerebral Palsy Quality of Life), FPS-R (Faces Pain Scale-Revised), GMFCS (Gross Motor Function Classification System), ICF (International Classification of Functioning, Disability and Health), MACS (Manual Abilities Classification System), OR (odds ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 12, 2019
Footnotes
Supported by the Cerebral Palsy Alliance Research Foundation (PG2115, K.O., S.P., M.K., A.M.) the National Health and Medical Research Council Centre for Research Excellence in Cerebral Palsy (K.O.).
Disclosures: Katarina Ostojic, Simon Paget, Maria Kyriagis, and Angela Morrow received grants from the Cerebral Palsy Alliance Research Foundation during the conduct of the study. Katarina Ostojic received grants from the National Health and Medical Research Council Centre during the conduct of the study.
Identification
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© 2019 by the American Congress of Rehabilitation Medicine
